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Organization
ROUND LAKE FAMILY DENTISTRY, PLLC
Active
Organization
ROUND LAKE FAMILY DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP ZHAN DDS (OWNER)
(612) 308-9416
Entity
Organization
Contact information
Practice address
13841 ROUND LAKE BLVD NW, ANDOVER, MN 55304-3664
(763) 427-0285
Mailing address
7493 147TH ST W STE 100, APPLE VALLEY, MN 55124-7570
(952) 432-7145
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/23/2018
Last updated
10/23/2018
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